Vasectomy - Frequently Asked Questions

What are the risks of vasectomy?

One study has shown that men who have had a vasectomy have an increased occurrence of prostate cancer after 20 years. Since this study, other results have noted that there is not an increase in frequency of prostate cancer. A panel of experts was convened by the National Institutes of Health to study the available research, and it concluded that the evidence for a link between vasectomy and prostate cancer was inconsistent and insufficient. No changes were recommended, including no increased screening for prostate cancer among men who have had vasectomies.

It is advised to use another form of birth control, for at least the first six weeks after the procedure. Subsequently, the man's semen is checked to ensure no sperm are present. The total charge for a vasectomy is typically less than $900.

Is a vasectomy effective?

While, the overall failure rate for vasectomy rate is 0.15 percent, this does not give an accurate picture of its real effectiveness. The majority of vasectomy failures happen during the first couple of months after the procedure, when live sperm may still exist in a man's semen. Couples must continue to use another method of birth control until the man has ejaculated about 20 times over as long as six months and tests have shown that no live sperm remain. If these tests are passed on, you may live to regret. There is a failure rate of 0.025 percent (one of every 4,000) because the vas deferentia manages to reconnect.

What if I change my mind?

It is easier to plan for the future than to predict the future. Nearly 1 in 100 men who undergo a vasectomy will attempt vasectomy reversal. Fortunately, microsurgical techniques developed in recent years have greatly improved the likelihood of success. Two types of surgical procedures are used to reverse vasectomy. In men who still have sperm present in their vas deferentia, vasovasostomy reconnects the vas. When no sperm are found (about one-third of all cases), the far ends of the vas deferentia can be directly connected to the epididymis, using a technique called vasoepididymostomy.

Neither method of reconnection is easy, definite or cheap. While both methods can often be done at an ambulatory surgery center, with the man going home the same day, vasovasostomy takes two to three hours, and vasoepididymostomy can take five. The range of cost is between $5,000 and $15,000. Overall, the rates of pregnancy are about 50 percent and 20 percent respectively, but the chances also depend on how recently the man had the vasectomy. For vasovasostomy, the chances of pregnancy are as high as three-quarters for the first three years, declining to about half for years three through eight, and as low as one-third after the fifteenth year. Vasectomy reversal actually turns up sperm in semen considerably more often than the pregnancy numbers suggest. It is commonly known that presence of sperm does not guarantee pregnancy, and pregnancy is the goal.

If reconnection fails, there is yet another option for couples who want children. In this procedure, sperm are aspirated directly from a man's testicle and injected into an egg removed from the woman. Once fertilization takes place, the egg can be implanted in the woman, where normal gestation can take place. Obviously, this is more complicated and expensive than reconnection, and the odds of success are lower.

Is sex different after vasectomy?

Not at all. Because the testicles supply less than 5 percent of the ejaculate, there's no noticeable difference in the semen. Erections and sex drive are unaffected. Freedom from worry of pregnancy often enhances a couple's sex life.

What about female sterilization?

A procedure in which a woman's fallopian tubes are severed or sealed off, which prevents the egg from being fertilized by sperm is known as tubal ligation. In contrast to vasectomy, which is a simple outpatient procedure, tubal ligation usually is more complex and may require a hospital stay. Occasionally tubal ligation can be performed at an ambulatory surgery center.

The most common tubal ligation procedure involves sealing off the woman's fallopian tubes with tiny metal rings or clips. This requires two incisions be made just below the navel. Tubal ligation charges, including surgeon's fees, operating room facility, and anesthesiologist's charges, range anywhere from $1,500 to $2,500. The procedure requires a general or regional anesthetic. A current study showed that there was an 18 percent incidence of reconnection after tubal ligation.

Regardless of the obvious advantages of vasectomy, more tubal ligations (about 600,000) than vasectomies (about 500,000) are performed each year. This is most likely due to the fact that women have traditionally taken the responsibility for birth control.

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